Shoulder dystocia: could it be deduced from the labor partogram?

The study was undertaken to test the hypothesis that shoulder dystocia might be suspected and reliably identified from the labor partogram. A retrospective analysis of 52 consecutive patients with shoulder dystocia was performed. The 52 controls were the next consecutive parturient matched for maternal age, gestational age at delivery, parity, presentation, and infants weight at delivery. The mean dilation rate was 2.1 +/- 1.9 cm/hr in shoulder dystocia group compared to 2.4 +/- 1.5 cm/hr in the control group. The incidence of protracted rate of less than 1 cm/hr was 14.3% in shoulder dystocia group and 13.5% in the control group. The mean duration of second stage was 38.3 +/- 30.7 minutes in the shoulder dystocia group compared to 35.5 +/- 32.5 minutes in the control group. Only 1.9% have had a prolonged second stage (more than 2 hours) in the shoulder dystocia group compared to 1.9% in the control group. The difference between the groups regarding the length of labor was not statistically significant. We conclude that protracted labor does not seem to be a risk factor for shoulder dystocia.